Evaluation of differences between observers and automatic-manual measurements in calculation of Doppler parameters.

OBJECTIVE: We aimed to search for differences between observers and automatic and manual measurements in calculations of Doppler parameters. METHODS: The middle cerebral artery (MCA), central retinal artery, ophthalmic artery (OA), common carotid artery (CCA), vertebral artery (VA), popliteal artery (PA), interlobar renal artery (IRA), and arcuate renal artery (ARA) were evaluated in 20 healthy subjects bilaterally. Peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (TAMAX), resistive index (RI), and pulsatility index (PI) were measured from the same spectrum manually by 3 observers and automatically. Results of 4 measurements were compared by analysis of variance and Pearson tests. RESULTS: The comparison of the 4 measurements revealed significant differences for most parameters except TAMAX of the OA, VA, and ARA and PSV, EDV, and PI of the PA. An automatic calculator yielded lower PSV, RI, and PI values (except the MCA and PA) and higher EDV values compared with manual measurements. The magnitudes of difference were in the range of 1% to 16% for velocities and 4% to 14% for RI and PI. The means of difference were 3.185 cm/s for PSV of the CCA and 0.054 for RI of the IRA. Correlation was high for PSV, EDV, and TAMAX in all arteries (except TAMAX of PA) and relatively low for PI and RI in most of the arteries. CONCLUSIONS: Although our study was performed on healthy subjects, our results showed that, in most cases, readers and the automatic approach disagreed on evaluation of Doppler parameters. This may be important in preventing false diagnoses in cases with Doppler values close to upper limits and may necessitate establishment of new limits for each method.     

正常青春期睾丸动脉血流参数与睾丸体积的相关性研究

目的:研究正常青春期睾丸各动脉血流参数与睾丸体积的相关性。方法:检测141例正常青春期男性的睾丸体积及睾丸内动脉(ITA)、睾丸包膜动脉(CA)、睾丸动脉(TA)的时间平均峰值血流速度(TAMX)、收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)和搏动指数(PI)、收缩期峰值/舒张末期血流速度(S/D)。各血流参数均与睾丸体积做相关性研究。结果:正常青春期ITA,CA,TA的TAMX,PSV和EDV均与睾丸体积存在正相关,相关系数均为1.00(P<0.01)。而PI,RI,S/D均与睾丸体积无相关性。结论:正常青春期ITA,CA,TA的血流速度均随睾丸体积的增大而逐渐增高,相关性良好。     

Evaluation of the early hemodynamic changes in carotid arteries during ventricular and dual chamber pacing

In spite of a wide choice of pacemakers, there are some problems in making more rational clinical decisions for individual patients since mode selection and programming is usually performed on the basis of a clinical hunch. The aim of this study was to measure the differences in carotid flow in patients with a pacemaker programmed in the dual chamber and in the single chamber pacing modes. Sixty patients with implanted bipolar DDD pacemakers were enrolled in this study. Blood peak systolic velocity (PSV) and end-diastolic velocity (EDV), cross-sectional area, resistive index (RI), and pulsatility index (PI) were measured in the common (CCA), internal (ICA), and external (ECA) carotid arteries before pacemaker implantation and after dual chamber and ventricular pacing at 60 beats/min. PSVs in the left CCA (79.3 +/- 24.9 cm/s) and right CCA (84.1 +/- 18.7) were shown to significantly decrease after VVI pacing (60.1 +/- 16.6 and 62.1 +/- 20.0, respectively). There was also a similar significant decrease in PSV in the left and right ICAs and ECAs. Besides PSV, RI, and PI in the left and right CCAs, ICAs, and ECAs significantly decreased after VVI pacing. There was no similar decrease after DDD pacing. Cross-sectional area and flow volume in the CCA, ICA, and ECA were similar after DDD and VVI pacing and before pacemaker implantation suggesting that cardiac output was similar when the measurements were recorded. Carotid artery PSVs, pulsatility, and RIs were found to be significantly decreased during VVI pacing compared to baseline and DDD pacing. The greater incidence of adverse cerebral outcomes in patients with VVI rather than DDD pacing may be partly due to decreased carotid PSVs.     

E-flow显像评价系统性硬化病患者指端微循环变化

目的 探讨高频超声结合E-flow显像评价系统性硬化病(systemic sclerosis,SSc)患者指端微循环病变的临床价值.方法 SSc患者 24 例,正常对照组 29 例,均行高频超声检查并结合E-flow显像,观察各组受试者左右手中指末节指端血管分布特征、走行,测量指掌侧固有动脉、指腹动脉及甲床动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)、平均血流速度(MV)、阻力指数(RI)及搏动指数(PI).结果 对照组末节指端血流信号丰富,可清晰显示指掌侧固有动脉、指腹动脉、甲床动脉及其细小分支;SSc末节指端血流显示欠清晰,连续性欠佳,血流分布明显减少.与对照组相比,SSc组中指末端指掌侧固有动脉、指腹动脉及甲床动脉PSV、EDV、MV均减低(P＜0.01),而RI及PI增高(P＜0.05).对照组左右侧指端动脉血流参数无明显差异(P＞0.05),而SSc组左侧指掌侧固有动脉PSV、EDV及MV指标较右侧增高,差异均有统计学意义(P＜0.05).结论 高频超声结合E-flow显像可敏感、准确地反映SSc患者的指端微循环变化,为临床评价SSc患者微血管病变情况提供了新方法.

Abstract：

Objective To investigate the clinical value of high frequency ultrasonography with E-flow imaging in the evaluation of fingertip's microcirculation changes in patients with systemic sclerosis(SSc).Methods Twenty-four SSc patients and 29 healthy subjects were involved.High frequency ultrasonography with E-flow imaging was used to observe the configuration and distribution of digital arteries in the last segment of left and right middle finger.Peak systolic velocity (PSV),end diastolic velocity (EDV),mean velocity(MV),vascular resistance index (RI) and pulsatility index(PI) of digital palmar propria arteries,nail bed arteries and finger ventral arteries were measured.Results In control group,rich blood supply was revealed within the fingertips.Digital palmar propria arteries,nail bed arteries and finger ventral arteries and their small branches were displayed clearly and continuously by E-flow imaging.While in SSc patients,the definition and continuity of fingertip's small vascular flow images were not as good as that in the control group,with the distribution of blood flow markedly reduced.compared with the control group,PSV,EDV and MV of digital palmar propria arteries,nail bed arteries,finger ventral arteries were decreased in SSc group(P＜0.01),but both RI and PI were increased(P＜0.05).There were no statistically significant differences between left and right fingertip's arteries index in normal control group (P＞0.05).But PSV,EDV and MV of left digital palmar propria arteries in SSc group were higher than that of the right(P＜0.05),whose differences bear statistic significance.Conclusions High frequency ultrasonography with E-flow imaging is sensitive and reliable to reflect fingertip's microcirculation changes and provide a new method to assess microvascular changes in SSc patients.     

Doppler assessment of fetal aortic isthmus blood flow in two different sonographic planes during the second half of gestation.

OBJECTIVE: To compare the reliability of Doppler blood flow measurements of the fetal aortic isthmus (AoI) according to whether the sampling plane is obtained from the traditional longitudinal aortic arch (LAA) view or the more recently described three vessels and trachea (3VT) view of the fetal upper mediastinum. METHODS: Doppler blood flow measurements of pulsatility index (PI), resistance index (RI), peak systolic (PSV), end-diastolic (EDV) and time-averaged maximum (TAMXV) velocities were performed in the AoI of 40 fetuses between 24 and 36 weeks of gestation. All measurements were sampled in two different sonographic planes of the AoI: the LAA view, at a few millimeters beyond the origin of the left subclavian artery, and the 3VT view, just before the V-shaped junction of the aortic and ductal arches. All scans were performed by the same observer. The reliability of Doppler blood flow measurements was assessed by calculating intraclass correlation coefficients (ICCs) and limits of agreement between the two different sonographic sites evaluating the AoI. RESULTS: Mean values of PI, RI, PSV, EDV and TAMXV were similar in the LAA and 3VT views. The PI and vascular velocities were reliably measured from both sonographic sites. ICCs for variability of measurements were 0.78, 0.63, 0.63, 0.60 and 0.55 for PI, RI, PSV, EDV and TAMXV, respectively. Limits of agreement revealed minimal disagreement between the two sites of evaluation of the AoI for all measurements. CONCLUSIONS: On the basis of our observations, Doppler blood flow measurements across the fetal AoI can be reliably obtained from both the 3VT and the traditional LAA sonographic views. Since the transverse upper thoracic 3VT plane is achievable in most fetal positions, Doppler study of the AoI appears to be easier than expected.     

Assessment of renal circulation in small for gestational age and appropriate for gestational age term newborns: a prospective study

PURPOSE: To compare selected parameters of renal circulation between small for gestational age (SGA) and appropriate for gestational age (AGA) newborns. METHODS: Fifty-two SGA and 100 AGA term newborns were examined. The size of the kidneys were measured, and renal blood flow in the central and intraparenchymal renal arteries were assessed via Doppler sonography. Peak systolic velocity (PSV), end diastolic velocity (EDV), mean blood flow velocity (V mean), resistance index (RI), and pulsatility index (PI) were determined and compared between the groups. RESULTS: No statistically significant differences in the velocity parameters were found between SGA and AGA infants in central renal arteries. Slightly higher RIs and PIs were seen in AGA newborns (RI, 0.76 +/- 0.13 versus 0.78 +/- 0.06 [p < 0.05]; PI, 1.65 +/- 0.54 versus 1.84 +/- 0.46 [p < 0.05]). There were statistically significant differences between the groups in all measured parameters in intraparenchymal arteries (RI, 0.57 +/- 0.11 versus 0.63 +/- 0.05 [p < 0.001]; PI, 0.89 +/- 0.26 versus 1.09 +/- 0.16 [p < 0.001]) except PSV (7.11 +/- 1.55 versus 7.14 +/- 0.81 cm/s [p > 0.05]). CONCLUSION: Based on our findings, we suggest that renal circulation is not negatively influenced by intrauterine growth restriction in SGA neonates compared with AGA newborns.     

彩色多普勒超声对兔膝骨性关节炎诊断及治疗的实验研究

目的　探讨彩色多普勒超声对实验性膝骨性关节炎诊断及治疗疗效观察的应用价值。方法　对 3 6只大白兔实验性膝骨性关节炎做治疗前后患肢股动脉下段的彩色多普勒超声检测 ,并做血液流变学及病理学分析。结果　患肢股动脉下段血流速明显减缓 ,阻力指数、搏动指数升高 (P <0 .0 1) ,关节表面粗糙 ,软骨变薄 ,关节腔积液。治疗后血流速增加 ,阻力指数、搏动指数降低 (P <0 .0 5 ) ,关节表面回声变清晰。结论　彩色多普勒超声对膝骨性关节炎的诊断及治疗疗效的观察具较高的应用价值     

多普勒超声对正常和小于胎龄儿动脉导管：血流速度波形的分析

为评价小于胎龄儿(SGAF)和正常胎儿动脉导管血流速度及波形,采用脉冲多普勒和连续多普勒对60例正常胎儿和40例SGAF进行纵向、横向扫描,测量其收缩期峰值(PSV)、舒张末期速度(EDV)和平均速度(MV)以及PI值,结果表明PSV、EDV、MV随妊娠时间增加而增大,在纵向扫描中,有相当的个体差异,其PI值无显著性改变.胎儿动脉导管的多普勒超声并不能作为畸形胎儿的诊断有用指标.     

经阴道彩色多普勒超声对输卵管妊娠中妊娠黄体的临床研究

目的探讨妊娠黄体在超声诊断输卵管妊娠(TP)中的临床意义。方法临床拟诊宫外孕患者50例,于术前行经阴道超声(TVS)检查。在确定TP包块的同时,对妊娠黄体进行观察,CDFI显示双侧子宫动脉输卵管支血流,检测收缩期最大流速(PSV)、舒张末期流速(EDV)、平均流速(TAmax)、搏动指数(PI)及阻力指数(RI),并进行统计学处理。结果在确诊为TP的40例中,超声诊断符合38例。妊娠黄体的声像图表现可分为:薄壁囊肿型、薄壁囊肿内部光点型、厚壁囊肿型、实质低回声型四种类型。超声显示妊娠黄体38例(95.0%),黄体与TP同侧33例(86.8%);与TP非同侧5例(13.2%)。黄体与TP同侧时,患侧输卵管动脉血流EDV、TAmax明显高于健侧,PI、RI则明显低于健侧(P<0.05),PSV双侧无统计学差异(P>0.05);黄体与TP非同侧时,双侧血流参数均无统计学意义(P>0.05)。结论妊娠黄体在超声诊断早期TP时具有重要的定位作用。     

高血压病左室心肌重构与颈动脉重构的相关性

目的探讨原发性高血压病左室心肌重构与颈动脉重构的相关性.方法63例原发性高血压患者(EH)和22例对照者行心脏及颈动脉超声检查,分别测量左室质量指数(LVMI)、颈总动脉干内-中膜厚度(CCA-IMT)、分叉处内-中膜厚度(BIMT)、斑块以及两侧颈总动脉、颈内动脉的血流动力学参数,EH组中,又分为LVMI正常组和LVMI增高组.结果EH组CCA-IMT和BIMT高于对照组,其中LVMI增高组最高.EH组颈动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)降低,PSV/EDV、阻力指数(RI)和搏动指数(PI)增高.斑块检出率及严重程度在LVMI增高组最高,LVMI正常组次之,两者均明显高于正常对照组.LVMI与IMT、BIMT、PI、RI呈正相关,与PSV、EDV呈负相关.结论高血压病颈动脉重构的发生早于左室心肌重构,且两者密切相关.     

叶间动脉血流动力学参数对慢性肾疾病的早期诊断价值

目的 探讨彩色多普勒超声检测叶间动脉血流动力学参数对慢性肾疾病(chronic kidney disease,CKD)的早期诊断价值.方法 运用彩色多普勒超声对78例CKD患者和65例健康人的叶间动脉进行超声检查,测量收缩期峰值流速(PSV)、舒张末期血流速度(EDV)、搏动指数(PI)、阻力指数(RI),同时进行血清...     

Fetal adrenal artery velocimetry measurements in appropriate-for-gestational age and intrauterine growth-restricted fetuses.

OBJECTIVE: To investigate adrenal artery blood flow in the fetus. DESIGN AND METHOD: Sixty-two appropriate-for-gestational-age (AGA) and 20 intrauterine growth-restricted (IUGR) fetuses were recruited to this cross-sectional study between 22 and 42 weeks of pregnancy in a tertiary referral fetal medicine unit of a university hospital. ENDPOINTS: Doppler velocimetry of the fetal adrenal, umbilical (UA), renal and middle cerebral arteries (MCA). Pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV), time-averaged maximum velocity (TAMXV) and cerebroplacental ratio (MCA RI/UA RI; CPR). Obstetric outcome. RESULTS: The adrenal artery was detected in 82% of the fetuses. All flow velocity waveforms obtained from the adrenal artery indicated low impedance blood flow. No significant changes in PI, RI, PSV and TAMXV occurred with advancing gestation. The blood flow parameters of the adrenal artery did not differ between AGA and IUGR fetuses. In five IUGR fetuses with signs of redistribution of cardiac output in favor of the brain, the adrenal artery velocimetry results were unremarkable. The adrenal artery PI, RI, PSV and TAMXV values were higher in female fetuses than in male fetuses (P < 0.05). A relationship was observed between the velocity measurements and the estimated fetal weight (P < 0.01). CONCLUSIONS: The fetal adrenal artery could be readily detected. We observed no redistribution of blood flow in favor of the fetal adrenals in IUGR fetuses which were not severely compromised.     

Effects of Cytotoxic T Lymphocyte-Associated Antigen 4 Immunoglobulin Combined with Microbubble-Mediated Irradiation on Hemodynamics of the Renal Artery in Rats with Diabetic Nephropathy

Cytotoxic T lymphocyte-associated antigen 4 immunoglobulin (CTLA-4-Ig) can inhibit the effect of B7-1 and improve renal hemodynamics in rats with diabetic nephropathy (DN). Nevertheless, a strategy that could increase the permeation of CTLA-4-Ig through endothelial cells and basement membrane remains to be discovered. We investigated the effect of CTLA-4-Ig combined with microbubble-mediated irradiation on the hemodynamics of renal arteries in DN rats. Rats were treated with CTLA-4-Ig and/or microbubble exposure. After 8 wk of intervention, color Doppler ultrasonography was used to detect peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV), systolic acceleration (SAC), pulsatility index (PI) and resistance index (RI) of the renal artery trunk. The CTLA-4-Ig + microbubble exposure group exhibited significantly higher PSV, EDV and MV than the CTLA-4-Ig group, which had significantly higher values than the non-intervention group. The CTLA-4-Ig + microbubble exposure group exhibited significantly lower SAC, PI and RI than the CTLA-4-Ig group, which had significantly lower values than the non-intervention group. Our results indicate that both CTLA-4-Ig and CTLA-4-Ig + microbubble exposure can reduce the blood flow resistance and improve the blood flow velocity of renal arteries in rats. Moreover, the effect of CTLA-4-Ig + microbubble exposure is better than that of CTLA-4-Ig alone. Our study provides a new, effective and non-invasive strategy for the treatment of DN.     

腹腔镜精索静脉高位结扎术对睾丸动脉血流参数的影响

目的 应用彩色多普勒血流成像(CDFI)技术观察腹腔镜左侧精索静脉高位结扎术对该侧睾丸内动脉(ITA)和包膜动脉(CA)血流参数的影响.方法 选择29例左侧精索静脉曲张并行同侧腹腔镜精索静脉高位结扎术的患者,使用CDFI技术在术前1周和术后3、6个月检测双侧CA和ITA向心支的收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)及搏动指数(PI).结果 手术前后比较,患者左侧ITA和CA的RI、PI及PSV值均降低,差异有统计学意义(P＜0.05),其中RI、PI的改变较PSV降低更明显(P＜0.01).术后6个月各指标较术后3个月下降更明显,差异有统计学意义(P＜0.05),但EDV无明显变化,差异无统计学意义.患者右侧ITA和CA的各血流参数值手术前后比较差异均无统计学意义.结论 腹腔镜精索静脉高位结扎术后患者患侧ITA和CA的血流动力学参数均有显著改善;ITA和CA的RI、PI值可作为检测腹腔镜精索静脉结扎术后患者手术效果的一项重要指标.     

超声在烟雾病颞浅动脉-大脑中动脉吻合术的应用研究

目的 探讨彩色多普勒超声评价烟雾病颞浅动脉-大脑中动脉吻合术手术疗效的应用价值.方法 25例烟雾病颞浅动脉-大脑中动脉吻合术患者,手术前及术后1周探测双侧颈外动脉、颞浅动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)、搏动指数(PI)及阻力指数(RI),并比较手术前后颈外动脉、颞浅动脉的血流参数变化情况.25例患者手术前及手术后1周行DSA检查,依据术后颞浅动脉向大脑中动脉分流程度分为大量、中等量及少量,比较不同组间颞浅动脉PSV、EDV、PI、RI.术后应用彩色多普勒超声沿手术切口追踪颞浅动脉全程,观察颞浅动脉血流方向及走行.结果 ①术后颈外动脉PSV、EDV较术前增快,PI、RI较术前降低,但差异无统计学意义.②术后颞浅动脉PSV、EDV较术前明显增快,PI、RI较术前显著减低.③术后DSA所示颞浅动脉向大脑中动脉分流量越大,颞浅动脉PSV、EDV越高,PI、RI越低.④术后彩色多普勒超声可追踪颞浅动脉全程,并在颞浅动脉入颅处探测到其血流方向由颅外流向颅内.结论 彩色多普勒超声可以评价吻合血管通畅性及分流程度,且与DSA有较好的一致性,可作为无创性评价颞浅动脉-大脑中动脉吻合术手术疗效的方法.     

正常胎儿主肺动脉多普勒流速曲线参数测值与孕龄相关性的研究

目的探讨正常胎儿主肺动脉多普勒流速曲线参数测值与孕龄的相关性。方法将孕龄为23～40周的252例正常胎儿按照孕龄分为10组,利用超声多普勒测量胎儿主肺动脉流速曲线参数：收缩期加速时间（AT）、射血时间（ET）、加速时间／射血时间（舳T）、收缩期峰值流速（PSV）、舒张期末流速（EDV）、平均流速（MV）、搏动指数（PI）、阻力指数（RI）。建立不同孕龄各流速曲线参数的正常参考值,对各参数与孕龄绘制散点图、进行相关和回归分析,选择最优化方程。结果252例正常胎儿中,胎儿主肺动脉多普勒流速曲线测量成功249例（98．8%,249／252）。胎儿主肺动脉多普勒流速曲线参数测值随孕龄增加的变化：AT、AT／ET、PSV、EDV、MV测值随孕龄增加而呈增大趋势（F=343．23、96．012、8．649、2．158、10．169,P均〈0．05）：PI测值随孕龄增加而呈减小趋势（F=2．346,P〈0．05）;ET、RI随孕龄增加测值无明显变化（F=0．883、1．534,P〉0．05）。AT、AT／ET、PSV、EDV、MV测值与孕龄呈显著线性正相关（r=0．898、0．868、0．446、0．203、0．507,P均〈0．01）;PI测值与孕龄呈显著线性负相关（r=-0．184,P〈0．01）;ET、RI测值与孕龄无相关性（r=-0．103、0．011,P均〉0．05）。结论胎儿主肺动脉为超声多普勒测量肺动脉流速曲线的可靠测量点。正常胎儿主肺动脉流速曲线参数与孕龄有一定相关性,AT、AT／ET与胎儿孕龄相关性最好。     

正常胎儿主肺动脉多普勒参数与孕周的关系

目的探讨正常胎儿妊娠中、晚期主肺动脉多普勒参数与孕周的关系。 方法将孕龄为21~40周的正常胎儿300例按照孕龄分为10组,分别为21~22^＋6周、23~24^＋6周、25~26^＋6周、27~28^＋6周、29~30^＋6、31~32^＋6周、33~34^＋6周、35~36^＋6周、37~38^＋6周和39~40^＋6周,每组30例。采用彩色超声仪测量收集正常胎儿主肺动脉多普勒参数：收缩期加速度时间（AT）、射血时间（ET）、收缩期峰值流速（PSV）、舒张期末流速（EDV）、平均流速（MV）、搏动指数（PI）和阻力指数（RI）。建立不同孕周主肺动脉多普勒参数的正常参考值,对各参数值和孕周进行相关和回归分析。 结果300例胎儿均获得满意的主肺动脉流速曲线,AT、AT/ET、PSV、EDV和MV与孕周呈线性正相关（r=0.866、0.848、0.457、0.242、0.506,P均<0.05）;PI与孕周呈线性负相关（r=-0.170,P<0.05）;ET、RI与孕周无相关性（r=0.195、-0.197,P均>0.05）。 结论正常胎儿主肺动脉多普勒参数与孕周有一定的相关性,AT、AT/ET与胎儿孕周相关性最好。     

Repeatability of power Doppler sonography of cervical lymph nodes

This study was undertaken to investigate the repeatability (intraobserver variability) of power Doppler sonography in assessment of cervical lymph nodes. Power Doppler sonography was performed twice in 20 healthy subjects to evaluate the repeatability of measurement of size, blood flow velocity (peak systolic velocity, PSV, and end diastolic velocity, EDV) and vascular resistance (resistance index, RI, and pulsatility index, PI) of cervical nodes. A total of 70 power Doppler sonograms were reviewed to evaluate the repeatability of assessment of vascular pattern, degree of vascularity and displacement of vessels of cervical lymphadenopathy. In the 20 subjects, 139 normal cervical nodes were detected in the first scan and they were re-scanned in the second scan. One node was detected in the second scan, but not in the first scan. Of the total, 50 cervical nodes showed arterial flow in both scans, and blood flow velocity and vascularity resistance were measured. The mean value of PSV, EDV, RI and PI have a higher repeatability than their highest and lowest values. There is a high repeatability in the measurement of maximum transverse diameter (97%), mean PSV (95%), mean EDV (96%), mean RI (86%) and mean PI (87%). The repeatability in evaluation of vascular pattern (85%), degree of vascularity (95%) and displacement of vessels (88%) are also high. Results suggest that power Doppler sonography is a reliable method in assessment of the vasculature of cervical lymph nodes.     

The role of Doppler sonography in predicting severity of acute pancreatitis

PURPOSE: To investigate the role of Doppler sonography (DUS) examination of major abdominal arteries in predicting severity of acute pancreatitis (AP). METHODS: Twenty-nine patients diagnosed with AP and 14 controls were blindly and prospectively evaluated with Doppler sonography. Disease severity was defined clinically according to acute physiology and chronic health evaluation (APACHE II) score and was classified as severe for APACHE II score > or =8. DUS examination included the measurement of peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), and resistance index (RI) of the celiac artery (CA) and superior mesenteric artery (SMA). Statistical analysis included Mann-Whitney U test, Student t test, and receiver operating characteristic curve analysis. RESULTS: Twelve patients had severe AP and 17 had mild AP. PSV, EDV, and PI of the CA and RI of the SMA were higher in the severe AP group than in the mild AP and control groups (p < 0.001 and p < 0.0001, respectively). The sensitivity and specificity were 100% and 94%, respectively, for a 87 cm/second CA PSV cutoff value, 75% and 100%, respectively, for a 22 cm/second CA EDV cutoff value, 92% and 82%, respectively, for a 1.29 CA PI cutoff value, and 100% and 100%, respectively, for a 0.86 SMA RI cutoff value. CONCLUSION: DUS can be useful in predicting the severity of AP in the early period of admission phase of the disease.     

老年视网膜动脉硬化患者的彩色多普勒超声检测分析

目的 :观测老年视网膜动脉硬化各期的视网膜中央动脉血流动力学变化 ,探讨视网膜中央动脉血流频谱参数特征及其临床应用价值。方法 :对 15 0例老年动脉硬化患者进行彩色多普勒超声检测视网膜中央动脉血流频谱参数 ,并与正常对照组进行对比研究。结果 :动脉硬化组Ⅰ期血管硬化与正常对照组各项参数比较 ,均未见统计差异 (P >0 .0 5 )。Ⅱ期血管硬化视网膜中央动脉RI明显高于正常对照组 (P <0 .0 1)。两组间的血流频谱参数 ,经 χ2 检验 ,有显著差异 (P <0 .0 1)。动脉硬化程度与RI呈正相关 ,与血管内径呈负相关 ,动脉硬化程度愈明显 ,视网膜中央动脉舒张末期血流速度减慢 ,血管内径缩小 ,搏动指数和阻力指数增大 ,呈较明显的低灌注、高回流状态。结论 :老年视网膜动脉硬化应用彩色多普勒超声检测的血流频谱参数能较准确的反映视网膜动脉各期的硬化情况 ,对判断心脑血管疾病的进展和预后提供有效信息。